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Updated: Jun 22, 2026
Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
The relation between endothelial dependent flow mediated dilation of the brachial artery and coronary collateral
Aydan Ongun Ozdemir1, Sadi Gulec, Nihal Uslu
1Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey. aongun@msn.com
Insights
This study found no link between brachial artery endothelial function, measured by flow-mediated dilation (FMD), and the development of coronary collaterals in patients with coronary stenosis. Systemic endothelial function does not appear to predict collateral growth.
Area of Science:
- Cardiovascular Research
- Vascular Biology
- Interventional Cardiology
Background:
- Endothelial dysfunction is a suspected factor in reduced coronary collateral formation.
- Coronary collaterals play a vital role in myocardial perfusion during stenosis.
Purpose of the Study:
- To examine the relationship between systemic endothelial function and the extent of coronary collateral development.
- To determine if flow-mediated dilation (FMD) predicts collateralization in patients with significant coronary artery disease.
Main Methods:
- Assessed endothelial function using flow-mediated dilation (FMD) of the brachial artery post-reactive hyperemia.
- Graded coronary collateral extent (0-3) using Rentrop classification in 171 patients with high-grade coronary stenosis or occlusion.
- Compared FMD and nitroglycerin-mediated dilation between patients with good (grade 2-3) and poor (grade 0-1) collaterals.
Main Results:
- No significant difference in FMD (11.5% vs 10.4%, p=0.214) or nitroglycerin-mediated dilation (13.4% vs 12.8%, p=0.521) was observed between good and poor collateral groups.
- Patients with poor collaterals were more likely to have diabetes (p=0.001) and less likely to use statins (p=0.083).
Conclusions:
- Systemic endothelial function, as assessed by brachial artery FMD, is not significantly associated with the extent of angiographically visible coronary collaterals.
- These findings suggest endothelial function may not be a primary determinant of coronary collateral development in this patient cohort.
Background:
Endothelial dysfunction is thought to be a potential mechanism for the decreased presence of coronary collaterals. The aim of the study was to investigate the association between systemic endothelial function and the extent of coronary collaterals.
Methods:
We investigated the association between endothelial function assessed via flow mediated dilation (FMD) of the brachial artery following reactive hyperemia and the extent of coronary collaterals graded from 0 to 3 according to Rentrop classification in a cohort of 171 consecutive patients who had high grade coronary stenosis or occlusion on their angiograms.
Results:
Mean age was 61 years and 75% were males. Of the 171 patients 88 (51%) had well developed collaterals (grades of 2 or 3) whereas 83 (49%) had impaired collateral development (grades of 0 or 1). Patients with poor collaterals were significantly more likely to have diabetes (p = 0.001), but less likely to have used statins (p = 0.083). FMD measurements were not significantly different among good and poor collateral groups (11.5 +/- 5.6 vs. 10.4 +/- 6.2% respectively, p = 0.214). Nitroglycerin mediated dilation was also similar (13.4 +/- 5.9 vs. 12.8 +/- 6.5%, p = 0.521).
Conclusion:
No significant association was found between the extent of angiographically visible coronary collaterals and systemic endothelial function assessed by FMD of the brachial artery.
